Provider Demographics
NPI:1447302229
Name:SHELLER, ELIZABETH T (APRN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:T
Last Name:SHELLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 21ST AVE S
Mailing Address - Street 2:#401
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-4930
Mailing Address - Country:US
Mailing Address - Phone:615-297-6808
Mailing Address - Fax:615-292-2355
Practice Address - Street 1:2323 21ST AVE S
Practice Address - Street 2:#401
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-4930
Practice Address - Country:US
Practice Address - Phone:615-297-6808
Practice Address - Fax:615-292-2355
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000054881101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3900857Medicare UPIN